Cannulated, modular femoral broach and surgical instrument handle

ABSTRACT

An orthopaedic surgical instrument assembly includes a surgical reamer, a cannulated broach, and an instrument handle. The broach includes a bore sized to slide over a shaft of the reamer. The handle attaches to the broach and also includes a bore sized to slide over a shaft of the reamer. A modular broach assembled from a number of broach segments may be used. Methods associated with the surgical instrument assembly are also disclosed.

CROSS-REFERENCE TO RELATED APPLICATIONS

The present application is a divisional application of U.S. applicationSer. No. 16/729,355, now U.S. Pat. No. 11,648,016, entitled “CANNULATED,MODULAR FEMORAL BROACH AND SURGICAL INSTRUMENT HANDLE,” which was filedon Dec. 28, 2019, the entirety of which is hereby incorporated byreference.

TECHNICAL FIELD

The present disclosure relates generally to orthopaedic instruments foruse in the performance of an orthopaedic joint replacement procedure,and more particularly to orthopaedic surgical instruments for use in theperformance of a revision knee replacement procedure.

BACKGROUND

Joint arthroplasty is a well-known surgical procedure by which adiseased and/or damaged natural joint is replaced by a prosthetic joint.For example, in a total knee arthroplasty surgical procedure, apatient's natural knee joint is partially or totally replaced by aprosthetic knee joint or knee prosthesis. A typical knee prosthesisincludes a tibial tray, a femoral component, and a polymer insert orbearing positioned between the tibial tray and the femoral component.The tibial tray generally includes a plate having a stem extendingdistally therefrom, and the femoral component generally includes a pairof spaced apart condylar elements, which include surfaces thatarticulate with corresponding surfaces of the polymer bearing. The stemof the tibial tray is configured to be implanted in asurgically-prepared medullary canal of the patient's tibia, and thefemoral component is configured to be coupled to a surgically-prepareddistal end of a patient's femur

From time-to-time, a revision knee surgery may need to be performed on apatient. In such a revision knee surgery, the previously-implanted kneeprosthesis is surgically removed and a replacement knee prosthesis isimplanted. In some revision knee surgeries, all of the components of thepreviously-implanted knee prosthesis, including, for example, the tibialtray, the femoral component, and the polymer bearing, may be surgicallyremoved. In other revision knee surgeries, only part of thepreviously-implanted knee prosthesis may be removed and replaced.

During a revision knee surgery, the orthopaedic surgeon typically uses avariety of different orthopaedic surgical instruments such as, forexample, cutting blocks, surgical reamers, broaches, drill guides,prosthetic trials, and other surgical instruments to prepare thepatient's bones to receive the knee prosthesis.

SUMMARY

According to one aspect of the disclosure, an orthopaedic surgicalinstrument system includes a broach having a tapered body extendingdistally from a first end to a second end, the tapered body having aplurality of cutting teeth defined therein. The broach includes an innerwall defining a first aperture on the first end and a second aperture onthe second end, and a bore sized to slide over a shaft of a surgicalreamer that extends from the first aperture to the second aperture.

In an embodiment, the orthopaedic surgical instrument system furtherincludes an instrument handle having an elongated body extendingdistally from a first end to strike plate. The instrument handleincludes an inner wall defining a third aperture on the first end of theinstrument handle and a bore sized to slide over the shaft of thesurgical reamer that extends distally from the third aperture into theelongated body. In an embodiment, the second end of the broach isconfigured to be removably secured to the first end of the instrumenthandle. In an embodiment, the broach includes a flange positioned withina slot defined in the second end of the broach, and the instrumenthandle includes a hook positioned at the first end of the instrumenthandle and configured to engage the flange of the broach.

In an embodiment, the orthopaedic surgical instrument system furtherincludes the surgical reamer. The surgical reamer includes a cuttinghead coupled to an elongated shaft. The elongated shaft is sized to bereceived within the bore of the broach.

According to another aspect, an orthopaedic surgical instrument assemblyincludes a first broach segment and a second broach segment. The firstbroach segment includes a tapered body extending from a proximal end toa distal end, the tapered body having a plurality of cutting teethdefined therein, and the second broach segment includes a tapered bodyextending from a proximal end to a distal end, the tapered body having aplurality of cutting teeth defined therein. The proximal end of thesecond broach segment is removably coupled to the distal end of thefirst broach segment. When coupled, the first broach segment and thesecond broach segment cooperate to define a bore that extends from afirst aperture defined in the proximal end of the first broach segmentto a second aperture defined in the distal end of the second broachsegment, wherein the bore is sized to slide over a shaft of a surgicalreamer. When coupled, the tapered body of the first broach segment andthe tapered body of the second broach segment form a tapered outersurface that widens from the proximal end of the first broach segment tothe distal end of the second broach segment.

In an embodiment, the second broach segment includes a dovetailpositioned on the proximal end of the second broach segment, and adovetail slot is defined in the distal end of the first broach segment.The dovetail slot is sized to receive the dovetail of the second broachsegment. In an embodiment, the first broach segment includes a balldetent positioned on the distal end of the first broach segment, and arecess is defined in the proximal end of the second broach segment,wherein the recess is sized to receive the ball detent of the firstbroach segment. In an embodiment, the distal end of the first broachsegment and the distal end of the second broach segment are eachconfigured to be removably attached to a surgical instrument handle.

In an embodiment, the orthopaedic surgical instrument assembly furtherincludes a third broach segment having a tapered body extending distallyfrom a proximal end to a distal end, the tapered body having a pluralityof cutting teeth defined therein, wherein the proximal end of the thirdbroach segment is removably coupled to the distal end of the secondbroach segment. When the third broach segment is coupled to the secondbroach segment, the bore further extends to an aperture defined in thedistal end of the third broach segment, and the tapered body of thethird broach segment extends the tapered outer surface that widens fromthe proximal end of the first broach segment to the distal end of thethird broach segment.

In an embodiment, the orthopaedic surgical instrument assembly furtherincludes a fourth broach segment having a tapered body extendingdistally from a proximal end to a distal end, the tapered body having aplurality of cutting teeth defined therein, wherein the proximal end ofthe fourth broach segment is removably coupled to the distal end of thethird broach segment. When the fourth broach segment is coupled to thethird broach segment, the bore further extends to an aperture defined inthe distal end of the fourth broach segment, and the tapered body of thefourth broach segment extends the tapered outer surface that widens fromthe proximal end of the first broach segment to the distal end of thefourth broach segment.

In an embodiment, the orthopaedic surgical instrument assembly furtherincludes a fifth broach segment having a tapered body extending distallyfrom a proximal end to a distal end, the tapered body having a pluralityof cutting teeth defined therein, wherein the proximal end of the fifthbroach segment is removably coupled to the distal end of the fourthbroach segment. When the fifth broach segment is coupled to the fourthbroach segment, the bore further extends to an aperture defined in thedistal end of the fifth broach segment, and the tapered body of thefifth broach segment extends the tapered outer surface that widens fromthe proximal end of the first broach segment to the distal end of thefifth broach segment.

In an embodiment, the orthopaedic surgical instrument assembly furtherincludes a sixth broach segment having a tapered body extending distallyfrom a proximal end to a distal end, the tapered body having a pluralityof cutting teeth defined therein, wherein the proximal end of the sixthbroach segment is removably coupled to the distal end of the fifthbroach segment. When the sixth broach segment is coupled to the fifthbroach segment, the bore further extends to an aperture defined in thedistal end of the sixth broach segment, and the tapered body of thesixth broach segment extends the tapered outer surface that widens fromthe proximal end of the first broach segment to the distal end of thesixth broach segment.

According to another aspect, a method of performing an orthopaedicsurgical procedure on a distal end of a patient's femur includesadvancing a cutting head of a surgical reamer into a medullary canal ofa patient's surgically prepared femur, wherein the surgical reamerfurther includes an elongated shaft coupled to the cutting head, slidinga bore defined through the broach over the elongated shaft in responseto advancing the cutting head into the medullary canal, wherein the boredefined through the broach extends from a proximal end of the broach toa distal end of the broach, and advancing the broach into the medullarycanal in response to sliding the bore defined through the broach overthe elongated shaft.

In an embodiment, the method further includes attaching the distal endof the broach to an instrument handle, wherein advancing the broachincludes impacting a strike plate of the instrument handle. In anembodiment, the method further includes sliding a bore defined in theinstrument handle over the elongated shaft after sliding the bore of thebroach over the elongated shaft, wherein the bore defined in theinstrument handle extends distally from a first end of the handle.

In an embodiment, the method further includes sliding a bore definedthrough a broach segment over the elongated shaft, wherein the boredefined through the broach segment extends distally from a proximal endof the broach segment to a distal end of the broach segment, and whereinthe proximal end of the broach segment contacts the distal end of thebroach, and advancing the broach segment into the medullary canal inresponse to sliding the bore defined through the broach shaft over theelongated shaft.

In an embodiment, the method further includes attaching the proximal endof the broach segment to the distal end of the broach in response tosliding the bore defined through the broach segment over the elongatedshaft, wherein advancing the broach segment includes advancing thebroach segment in response to attaching the proximal end of the broachsegment.

In an embodiment, the method further includes removing the broach fromthe medullary canal in response to advancing the broach into themedullary canal, and attaching the proximal end of the broach segment tothe distal end of the broach in response to removing the broach from themedullary canal. In an embodiment, sliding the bore defined through thebroach segment over the elongated shaft includes sliding the boredefined through the broach and the bore defined through the broachsegment over the elongated shaft in response to attaching the proximalend of the broach segment to the distal end of the broach.

BRIEF DESCRIPTION OF THE DRAWINGS

The detailed description particularly refers to the following figures,in which:

FIG. 1 is an exploded perspective view of a group of orthopaedicsurgical instruments of an orthopaedic surgical instrument system;

FIG. 2 is a perspective view of the group of orthopaedic surgicalinstruments of FIG. 1 ;

FIGS. 3-5 are views of a patient's femur and the orthopaedic surgicalinstrument system of FIGS. 1-2 as the orthopaedic surgical instrumentsystem is used in a procedure;

FIG. 6 is an elevation view of a modular broach that may be used withthe orthopaedic surgical instrument system of FIGS. 1-2 ;

FIG. 7 is an exploded cross-sectional view of the modular broach of FIG.6 ; and

FIGS. 8-12 are cross-sectional views of possible configurations of themodular broach of FIGS. 6-7 .

DETAILED DESCRIPTION OF THE DRAWINGS

While the concepts of the present disclosure are susceptible to variousmodifications and alternative forms, specific exemplary embodimentsthereof have been shown by way of example in the drawings and willherein be described in detail. It should be understood, however, thatthere is no intent to limit the concepts of the present disclosure tothe particular forms disclosed, but on the contrary, the intention is tocover all modifications, equivalents, and alternatives falling withinthe spirit and scope of the invention as defined by the appended claims.

Terms representing anatomical references, such as anterior, posterior,medial, lateral, superior, inferior, etcetera, may be used throughoutthe specification in reference to the orthopaedic implants andorthopaedic surgical instruments described herein as well as inreference to the patient's natural anatomy. Such terms havewell-understood meanings in both the study of anatomy and the field oforthopaedics. Use of such anatomical reference terms in the writtendescription and claims is intended to be consistent with theirwell-understood meanings unless noted otherwise.

Referring now to FIGS. 1 and 2 , a group of orthopaedic surgicalinstruments of an orthopaedic surgical instrument system 10 (hereinafterinstrument system 10) is shown. What is meant herein by the term“orthopaedic surgical instrument” or “orthopaedic surgical instrumentsystem” is a surgical tool for use by a surgeon in performing anorthopaedic surgical procedure. As such, it should be appreciated that,as used herein, the terms “orthopaedic surgical instrument” and“orthopaedic surgical instruments” are distinct from orthopaedicimplants or prostheses that are surgically implanted in the body of thepatient.

The system 10 includes a surgical reamer 12, a cannulated broach 26, andan instrument handle 48. As described in greater detail below, a surgeonmay use the system 10 in an orthopaedic procedure to prepare a patient'sdistal femur to receive a femoral implant, for example during a kneerevision procedure. In use, the surgeon reams the medullary canal of thepatient's femur using the reamer 12. With the reamer 12 remaining in thefemoral canal, the surgeon slides the cannulated broach 26 and handle 48over the reamer 12 and then impacts the handle 48 to advance the broach26 into the patient's femur. During impaction, the reamer 12 guides thebroach 26 into the correct position within the patient's femur. Afterbroaching is completed, the surgeon may then remove the broach 26 andthe reamer 12 and install a sleeved femoral component or otherprosthesis in the patient's femur. Thus, the system 10 allows thesurgeon to broach the patient's femur without attaching a stem trial,stem pilot, or other intramedullary instrument to the proximal end ofthe broach 26. Accordingly, the system 10 may reduce the risk of damageto the stem trial during impaction (e.g., reduce risk of damage tothreaded connections) as compared to conventional systems. Further,although illustrated in the present disclosure as a femoral broach 26,it should be understood that the concepts of this disclosure may also beapplied to other surgical instruments, including tibial broaches orother broaches.

In the illustrative embodiment, each instrument of the instrument system10 is formed from a metallic material, such as, for example, stainlesssteel or cobalt chromium. The surgical reamer 12 includes a cutting head14 and an elongated shaft or shank 22 secured to the cutting head 14.The cutting head 14 extends from a tip 16 to a distal base 18 that iscoupled to the shaft 22. As shown, the shaft 22 of the surgical reamer12 has a distal end 24 that fits into a manual handle or the chuck of arotary power tool.

The cutting head 14 of the reamer 12 includes a plurality of cuttingflutes 20 extending between the tip 16 and the base 18. When thesurgical reamer 12 is positioned in the medullary canal 82 (see FIG. 3 )of the patient's femur and rotated, the cutting flutes 20 of the cuttinghead 14 ream or otherwise cut the bone tissue of the femur. In theillustrative embodiment, the tip 16 of the cutting head 14 is conical.It should be appreciated that other reamers having cutting heads ofdifferent configurations may be provided. For example, the outerdiameter of the cutting head may vary to produce reamed canals sized toaccommodate prosthetic components of different sizes. Additionally, thelength of the cutting head may vary to change the depth of the reamedcanal.

As described above, the instrument system 10 includes the cannulatedbroach 26, which is illustratively a femoral broach configured to bepositioned in the medullary canal 82 of the patient's femur. The broach26 includes an outer surface 34 extending from a proximal end 28 to adistal end 30. The outer surface 34 is tapered, with the diameter of thebroach 26 increasing from the proximal end 28 to the distal end 30.

A plurality of cutting teeth 36 are formed on the outer surface 34between the proximal end 28 and the distal end 30. As described ingreater detail below, the cutting teeth 36 are configured to engage thebone surrounding the medullary canal 82 when the broach 26 is insertedtherein. It should be appreciated that multiple broaches 26 havingdifferent configurations may be provided in the instrument system 10.For example, the outer diameter and/or length of each broach 26 may varyto produce different sized canals to accommodate prosthetic componentsof different sizes.

The broach 26 includes a boss 32 positioned at the proximal end 28, andincludes a substantially planar distal surface 38 positioned at thedistal end 30 thereof. The boss 32 at the proximal end 28 has a circularaperture 40 defined therein, and a circular aperture 44 is defined inthe distal surface 38. An inner wall 42 extends between the proximal end28 and the distal end 30, and defines the apertures 40, 44. Accordingly,the inner wall 42 defines a bore 46 that extends through the broach 28from the proximal end 28 to the distal end 30. The bore 46 is sized toreceive and slide over the shaft 22 of the reamer 12 (as well as thedistal end 24 thereof).

As described above, the instrument system 10 includes the instrumenthandle 48, which includes an elongated body 50 that extends from aproximal end 52 to a distal strike plate 54. The proximal end 52 has anaperture 56 defined therein. An inner wall 58 extends inwardly from theproximal end 52 and defines the aperture 56. The inner wall 58 defines abore 60 that extends inwardly from the proximal end 52 through the body50. Similar to the bore 46, the bore 60 is sized to receive and slideover the shaft 22 of the reamer 12. As described further below, the bore60 extends deep enough within the body 50 to contain the shaft 22 whenthe broach 26 is fully seated within the patient's femur. In theillustrative embodiment, the bore 60 does not extend entirely throughthe body 50 to the strike plate 54.

As shown in FIGS. 1 and 2 , the illustrative body 50 includes a gripconfigured receive the hand of a surgeon or other user to allow the userto manipulate the handle 48. Accordingly, parts of the body 50 may becoated in a rubberized or textured material to improve grip stability.In some embodiments, the body 50 may be assembled from multiple unitsincluding the grip.

As shown, the instrument handle 48 includes the distal strike plate 54,which is attached to a distal end of the body 50. The strike plate 54 issecurely attached to the rest of the handle 48, for example bymechanically threading onto the end of the grip of the body 50. Thestrike plate 54 includes a durable distal surface 62 suitable for usewith a striking tool such as a mallet, sledge, or other impaction tool.The distal surface 62 is large enough to cover the grip in order toshield the hand of the user. In use, the surgeon may impact the strikeplate 54 to advance the broach 26 into the medullary canal of thepatient's femur. The surgeon may impact an underside surface 64 of thestrike plate 54 to remove the broach 26 from the patient's femur.

The illustrative handle 48 includes a detachable broach stop 66connected to the body 50. The broach stop 66 is configured to providevisual, tactile, or other feedback to allow the surgeon to determinewhen the broach 26 has been advanced to the correct position in thepatient's femur. For example, the illustrative broach stop 66 includes abase plate that defines a substantially planar proximal surface that maybe used by the surgeon to seat the broach 26 at the proper depth in thepatient's medullary canal. The broach stop 66 may be attached to one ofmultiple mounting positions on the body 50 to adjust the target depthfor the broach 26.

The handle 48 further includes an attachment mechanism 68 that isconfigured to secure the broach 26 to the instrument handle 48.Referring now to FIG. 4 , one embodiment of the attachment mechanism 68is shown. As shown, the attachment mechanism 68 includes a spring-loadedhook 70 that extends outwardly from the proximal end 52 of the handle48. The distal end 30 of the broach 26 has a slot 72 defined therein.The slot 72 extends inwardly from the outer surface 34 through thedistal surface 38 to a side wall 74. A flange 76 extends from the sidewall 74 into the slot 72. As shown, the flange 76 is positioned adjacentto the aperture 44. When the broach 26 is secured to the handle 48, thehook 70 of the attachment mechanism 68 engages the flange 76 and retainsthe broach 26 against the handle 48. When the broach 26 is attached tothe handle 48, the apertures 44, 56 and the bores 46, 60 align, allowingthe shaft 22 of the reamer 12 to slide through the broach 26 and intothe handle 48. The broach 26 is released from the handle 48 when thehook 70 disengages the flange 76, for example when a surgeon operates alever to disengage the hook 70.

The instrument assembly 10 may be utilized during the performance of anorthopaedic surgical procedure similar to that shown in FIGS. 3-5 . Asurgeon initially prepares a distal end 80 of a patient's femur 78, forexample by resecting the distal surface of the femur 78 and opening themedullary canal 82. The surgeon then inserts the surgical reamer 12 intothe medullary canal 82, as shown in FIG. 3 . The surgeon may use thereamer 12 to drill and/or ream the medullary canal 82 to the depthand/or diameter required to receive the broach 26. Multiple drills orreamers may be used to increase the size of the opening of the medullarycanal formed on the distal end of the patient's femur. When the reamingoperation is complete, the medullary canal 82 is ready to receive thebroach 26. The reamer 12 remains positioned in the medullary canal 82.

After preparing the medullary canal 82, the surgeon secures the broach26 to the handle 48 as shown in FIG. 4 . As described above, when thesurgeon attaches the proximal end 52 of the handle 48 to the distal end30 of the broach 26, the hook 70 of the attachment mechanism 68 engagesthe flange 76 and retains the broach 26 against the handle 48.

Next, as shown in FIG. 5 , the surgeon slides the bore 46 of the broach26 over the shaft 22 of the reamer 12 and advances the broach 26 intothe medullary canal 82. Depending on the length of the shaft 22 and thedepth of the reamer 12 in the medullary canal 82, the bore 60 of thehandle 48 may also slide over the shaft 22. The surgeon may then drivethe broach 26 into the femur 78 by striking the strike plate 54 of theinstrument handle 48 with mallet, sledge, or other impaction tool. Theshaft 22 of the reamer 12 guides and stabilizes the broach 26 as itadvances into the bone. As the broach 26 is driven into the bone, thecutting teeth 38 of the broach 26 engage the patient's femur 78 to shapethe medullary canal 82 to receive the prosthetic femoral component or afemoral trial component. The surgeon may advance the broach 26 into themedullary canal 82 until the broach 26 is correctly in position, forexample, when the broach stop 66 engages the distal surface 80 of thefemur 78. After broaching, the surgeon may remove the broach 26 andrepeat broaching with a different broach 26, for example withprogressively larger broaches 26 until rotational stability is achieved.

After the final broach 26 is in position and any resection is complete,the surgeon may further prepare the medullary canal 82 and the femur 78to receive a prosthetic implant. The surgeon may release the instrumenthandle 48 from the broach 26 and remove the instrument handle 48. Afterremoving the instrument handle 48, the broach 26 and the reamer 12remain seated within the medullary canal 82. To continue preparation,the surgeon may attach one or more other instruments to the broach 26and/or reamer 12, such as cutting guides, adapters, trial components, orother instruments.

After completing preparation of the patient's femur 78, the surgeon mayreattach the instrument handle 48 to the broach 26 and remove the broach26 from the medullary canal 82. After removing the broach 26, thesurgeon may also remove the reamer 12 from the medullary canal 82. Afterremoval, the surgeon may proceed with implantation of prostheticcomponents.

Referring now to FIGS. 6-12 , a modular femoral broach 100 is shown. Themodular broach 100 includes multiple broach segments 102 that may beattached together by a surgeon to form the broach 100. As describedfurther below, the surgeon may select different broach segments 102 toassemble the broach 100, and the size (e.g., length and diameter) of theassembled broach 100 is determined by the included broach segments 102.By allowing the surgeon to assemble a modular broach 100 from broachsegments 102, the modular broach 100 may be used in place of multiplebroaches of different sizes. For example, the modular broach 100 may beused with the instrument system 10 in place of multiple cannulatedbroaches 26 as described above in connection with FIGS. 1-5 . Eachbroach segment 102 is typically smaller than a complete broach; thus,the modular broach 100 may save size, weight, and/or cost as compared tosets of complete broaches.

As shown in FIG. 6 , the assembled, modular broach 100 is illustrativelya femoral broach configured to be positioned in the medullary canal 82of the patient's femur. The illustrative broach 100 includes an outersurface 134 extending from a proximal end 128 to a distal end 130. Theouter surface 134 is tapered, with the diameter of the broach 126increasing from the proximal end 128 to the distal end 130.

A plurality of cutting teeth 136 are formed on the outer surface 134between the proximal end 128 and the distal end 130. Similar to thebroach 26 described above, the cutting teeth 136 are configured toengage the bone surrounding the medullary canal 82 when the broach 100is inserted therein.

The broach 100 includes a boss 132 positioned at the proximal end 128,and a substantially planar distal surface 138 positioned at the distalend 130 thereof. The boss 132 at the proximal end 128 has a circularaperture 140 defined therein, and a circular aperture 144 is defined inthe distal surface 138. An inner wall 142 extends between the proximalend 128 and the distal end 130, and defines the apertures 140, 144.Accordingly, the inner wall 142 defines a bore 146 that extends throughthe broach 100 from the proximal end 128 to the distal end 130. Similarto the bore 46 of the broach 26, the bore 146 of the broach 100 is sizedto receive and slide over the shaft 22 of the reamer 12.

As shown in FIGS. 6-7 , the broach segments 102 of the broach 100include a proximal broach segment 148, multiple middle broach segments150, and a distal broach segment 160. The broach 100 illustrativelyincludes four middle broach segments 152, 154, 156, 158; however, inother embodiments, the broach 100 may include other numbers of middlebroach segments 150. Each of the broach segments 102 includes a taperedouter surface 134 and a plurality of cutting teeth 136 formed on theouter surface 134. The segments 102 increase in diameter progressivelyfrom the proximal segment 148 through the middle segments 152, 154, 156,158 to the distal segment 160.

As shown in FIG. 7 , the proximal segment 148 extends from the proximalend 128 of the broach 100 to a distal end 162 of the proximal segment148. An aperture 164 is defined in the distal end 162. The inner wall142 extends between the proximal end 128 and the distal end 162 anddefines the apertures 140, 164. Accordingly, the bore 146 extendsthrough the proximal segment 148 from the proximal end 128 to the distalend 162.

A dovetail slot 166 is defined in the distal end 162 of the proximalsegment 148. An inner wall 168 extends from the distal end 162 inward toa slot bottom 170 to define the dovetail slot 166. As shown, thedovetail slot 166 is wider at the slot bottom 170 than at the distal end162.

The proximal segment 148 further includes a pair of ball detents 172positioned at the distal end 162. Each ball detent 172 includes a ball174 and a spring 176. The spring 176 biases the ball 174 to extendoutward from the proximal end 162. When the spring 176 is compressed,the ball 174 may be retracted within the proximal segment 148. Each ofthe ball detents 172 is adjacent to an outer shoulder 178, which is aflat part of the outer surface 134 that does not include the cuttingteeth 136.

Similar to the proximal segment 148, the middle segment 152 extends froma proximal end 180 to a distal end 162. An aperture 182 is defined inthe proximal end 180, and an aperture 164 is defined in the distal end162. The inner wall 142 extends between the proximal end 180 and thedistal end 162 and defines the apertures 182, 164. Accordingly, the bore146 extends through the middle segment 152 from the proximal end 180 tothe distal end 162.

The proximal end 180 includes a dovetail 184. The dovetail 184 extendsoutwardly from a base 186 attached to the proximal end 180 to a free end188. The free end 188 is wider than the base 186 such that the dovetail184 is sized and shaped to be received within the dovetail slot 166 ofthe proximal segment 148. A pair of recesses 190 are further defined inthe proximal end 180. Each recess 190 is sized to receive a ball 174 ofa ball detent 172. The proximal end 180 further includes an innershoulder 192 adjacent to each recess 190. As described further below,when the segments 148, 152 are attached, the dovetail 184 is retainedwithin the dovetail slot 166, and the ball detents 172 cooperate withthe recesses 190 to align the aperture 182 of the middle segment 152with the aperture 164 of the proximal segment 148.

Similar to the proximal segment 148, a dovetail slot 166 is defined inthe distal end 162 of the middle segment 152. An inner wall 168 extendsfrom the distal end 162 inward to a slot bottom 170 to define thedovetail slot 166. As shown, the dovetail slot 166 is wider at the slotbottom 170 than at the distal end 162.

Also similar to the proximal segment 148, the middle segment 152 furtherincludes a pair of ball detents 172 positioned at the distal end 162.Each ball detent 172 includes a ball 174 and a spring 176. The spring176 biases the ball 174 to extend outward from the proximal end 162.When the spring 176 is compressed, the ball 174 may be retracted withinthe middle segment 152. Each of the ball detents 172 is adjacent to anouter shoulder 178, which is a flat part of the outer surface 134 thatdoes not include the cutting teeth 136.

As shown in FIG. 7 , each of the other middle segments 154, 156, 158includes components similar to the middle segment 152, including adovetail 184, a dovetail slot 166, ball detents 172, and part of thebore 146. The description of those components is not repeated herein soas not to obscure the present disclosure.

Similar to each of the middle segments 150, the distal segment 160extends from a proximal end 180 to the distal end 130. An aperture 182is defined in the proximal end 180. The inner wall 142 extends betweenthe proximal end 180 and the distal end 130 and defines the apertures182, 144. Accordingly, the bore 146 extends through the distal segment160 from the proximal end 180 to the distal end 130.

The proximal end 180 of the distal segment 160 includes a dovetail 184.The dovetail 184 extends outwardly from a base 186 attached to theproximal end 180 to a free end 188. The free end 188 is wider than thebase 186 such that the dovetail 184 is sized and shaped to be receivedwithin the dovetail slot 166 of the middle segment 158. A pair ofrecesses 190 are further defined in the proximal end 180. Each recess190 is sized to receive a ball 174 of a ball detent 172. The proximalend 180 further includes an inner shoulder 192 adjacent to each recess190. As described further below, when the segments 158, 160 areattached, the dovetail 184 is retained within the dovetail slot 166, andthe ball detents 172 cooperate with the recesses 190 to align theaperture 182 of the distal segment 160 with the aperture 164 of themiddle segment 158. Note that the illustrative distal segment 160 doesnot include a dovetail slot or ball detents.

As shown in FIGS. 8-12 , the broach segments 102 may be combined toassemble modular broaches 100 of varying sizes. Each combination ofbroach segments 102 shown in FIGS. 8-12 may have the same size or otherouter geometry as a corresponding broach 26 of a set of broaches 26 asdescribed above in connection with the instrument system 10. Of course,it should be noted that the proximal segment 148 may be used as a broach100 without attaching any other broach segments 102. In thatcircumstance, the proximal segment 148 may have the same size as thesmallest broach 26 of the set of broaches 26.

Referring now to FIG. 8 , the middle broach segment 152 may be attachedto the proximal broach segment 148. The segments 148, 152 may beattached by sliding the dovetail 184 of the middle broach segment 152into the dovetail slot 166 of the proximal segment 148. As the segments148, 152 are attached, the outer shoulder 178 of the proximal segment148 engages the inner shoulder 192 of the middle segment 152. Thedovetail 184 is slid into the dovetail slot 166 until the ball detents172 of the proximal segment 148 engage the recesses 190 of the middlesegment 152. As shown in FIG. 8 , when the broach segments 148, 152 areattached, the bore 146 extends through the segments 148, 152, and thetapered outer surface 134 extends along the segments 148, 152. As shown,the outer surface 134 widens from the proximal end 128 of the proximalsegment 148 to the distal end 130 of the middle segment 152.

Referring now to FIG. 9 , the middle broach segment 154 may be attachedto the broach segments 148, 152. The segment 154 may be attached to thesegments 148, 152 by sliding the dovetail 184 of the broach segment 154into the dovetail slot 166 of the broach segment 152. As the segments152, 154 are attached, the outer shoulder 178 of the broach segment 152engages the inner shoulder 192 of the broach segment 154. The dovetail184 is slid into the dovetail slot 166 until the ball detents 172 of thebroach segment 152 engage the recesses 190 of the broach segment 154. Asshown in FIG. 9 , when the broach segments 148, 152, 154 are attached,the bore 146 extends through the segments 148, 152, 154 and the taperedouter surface 134 extends along the segments 148, 152, 154. As shown,the outer surface 134 widens from the proximal end 128 of the proximalsegment 148 to the distal end 130 of the broach segment 154.

Referring now to FIG. 10 , the middle broach segment 156 may be attachedto the broach segments 148, 152, 154. The segment 156 may be attached tothe segments 148, 152, 154 by sliding the dovetail 184 of the broachsegment 156 into the dovetail slot 166 of the broach segment 154. As thesegments 154, 156 are attached, the outer shoulder 178 of the broachsegment 154 engages the inner shoulder 192 of the broach segment 156.The dovetail 184 is slid into the dovetail slot 166 until the balldetents 172 of the broach segment 154 engage the recesses 190 of thebroach segment 156. As shown in FIG. 10 , when the broach segments 148,152, 154, 156 are attached, the bore 146 extends through the segments148, 152, 154, 156 and the tapered outer surface 134 extends along thesegments 148, 152, 154, 156. As shown, the outer surface 134 widens fromthe proximal end 128 of the proximal segment 148 to the distal end 130of the broach segment 156.

Referring now to FIG. 11 , the middle broach segment 158 may be attachedto the broach segments 148, 152, 154, 156. The segment 158 may beattached to the segments 148, 152, 154, 156 by sliding the dovetail 184of the broach segment 158 into the dovetail slot 166 of the broachsegment 156. As the segments 156, 158 are attached, the outer shoulder178 of the broach segment 156 engages the inner shoulder 192 of thebroach segment 158. The dovetail 184 is slid into the dovetail slot 166until the ball detents 172 of the broach segment 156 engage the recesses190 of the broach segment 158. As shown in FIG. 11 , when the broachsegments 148, 152, 154, 156, 158 are attached, the bore 146 extendsthrough the segments 148, 152, 154, 156, 158 and the tapered outersurface 134 extends along the segments 148, 152, 154, 156, 158. Asshown, the outer surface 134 widens from the proximal end 128 of theproximal segment 148 to the distal end 130 of the broach segment 158.

Referring now to FIG. 12 , the distal broach segment 160 may be attachedto the broach segments 148, 152, 154, 156, 158. The segment 160 may beattached to the segments 148, 152, 154, 156, 158 by sliding the dovetail184 of the broach segment 160 into the dovetail slot 166 of the broachsegment 158. As the segments 158, 160 are attached, the outer shoulder178 of the broach segment 158 engages the inner shoulder 192 of thebroach segment 160. The dovetail 184 is slid into the dovetail slot 166until the ball detents 172 of the broach segment 158 engage the recesses190 of the broach segment 160. As shown in FIG. 12 , when the broachsegments 148, 152, 154, 156, 158, 160 are attached, the bore 146 extendsthrough the segments 148, 152, 154, 156, 158, 160 and the tapered outersurface 134 extends along the segments 148, 152, 154, 156, 158, 160. Asshown, the outer surface 134 widens from the proximal end 128 of theproximal segment 148 to the distal end 130 of the broach segment 160.

The modular broach 100 may be utilized during the performance of anorthopaedic surgical procedure similar to that shown in FIGS. 3-5 . Asdescribed above and as shown in FIG. 3 , the surgeon may prepare themedullary canal 82 of the patient's femur 78 by reaming the medullarycanal with the reamer 12. When the reaming operation is complete, themedullary canal 82 is ready to receive the broach 100, and the reamer 12remains positioned in the medullary canal 82.

After preparing the medullary canal 82, the surgeon may select acombination of broach segments 102 and assemble the modular broach 100having a desired size. In the illustrative embodiment, the surgeon mayassemble a modular broach 100 having one of six possible sizes. Inparticular, the surgeon may select the proximal segment 148 alone or mayselect among the five combinations of segments 102 shown in FIGS. 8-12 .The surgeon may assemble the modular broach 100 by attaching thesegments 102 as described above in connection with FIGS. 8-12 .

After selecting and/or assembling the modular broach 100, the surgeonsecures the modular broach 100 to the handle 48, similar to theprocedure shown in FIG. 4 . Next, similar to the procedure shown in FIG.5 , the surgeon slides the bore 146 of the broach 100 over the shaft 22of the reamer 12 and advances the broach 100 into the medullary canal82. Depending on the length of the shaft 22 and the depth of the reamer12 in the medullary canal 82, the bore 60 of the handle 48 may alsoslide over the shaft 22. The surgeon may then drive the broach 100 intothe femur 78 by striking the strike plate 54 of the instrument handle 48with mallet, sledge, or other impaction tool. The shaft 22 of the reamer12 guides and stabilizes the broach 100 as it advances into the bone.The shaft 22 also stabilizes the segments 102 of the broach relative toeach other as the broach 100 advances along the shaft 22. As the broach100 is driven into the bone, the cutting teeth 38 of the broach 100engage the patient's femur 78 to shape the medullary canal 82 to receivethe prosthetic femoral component or a femoral trial component. Thesurgeon may advance the broach 100 into the medullary canal 82 until thebroach 100 is correctly in position, for example, when the broach stop66 engages the distal surface 80 of the femur 78. After broaching, thesurgeon may remove the broach 100 and repeat broaching with a differentconfiguration of the modular broach 100. For example, the surgeon mayattach one or more additional segments 102 to the broach 100 toprogressively increase the size of the broach 100 until rotationalstability is achieved.

Additionally or alternatively, in some embodiments, additional broachsegments 102 may be attached to the modular broach 100 without removingthe broach 100 from the medullary canal 82. In those embodiments, thebroach segments 102 may include an attachment mechanism other than thedovetail 184 and dovetail slot 166 arrangement of the illustrativeembodiment. For example, the broach segments 102 may include a hook andflange arrangement similar to the handle 48 and broach 26 of FIGS. 1-5 .

In those embodiments, the surgeon may advance the broach 100 into themedullary canal 82 until the broach 100 is in position, for example,when the broach stop 66 engages the distal surface 80 of the femur 78.The surgeon may detach the handle 48 from the broach 100 and remove thehandle 48. After removing the handle 48, the reamer 12 and the broach100 remain in the medullary canal 82, and the shaft 22 extends out ofthe distal end 130 of the broach 100. The surgeon selects thenext-larger broach segment 102 to attach to the broach 100. For example,after the proximal segment 148 has been positioned in the medullarycanal 82, the surgeon may select the middle segment 152, after themiddle segment 152 has been positioned in the medullary canal 82, thesurgeon may select the middle segment 154, and so on. The surgeon slidesthe bore 146 of the selected broach segment 102 over the shaft 22 of thereamer 12 and advances the broach segment 102 to attach to the broach100. The surgeon may then attach the handle 48 to the newly extendeddistal end 130 of the modular broach 100 and continue broaching themedullary canal 82. Thus, in those embodiments, the surgeon mayprogressively enlarge the medullary canal 82 without removing the broach100 from the canal 82.

As described above, after the final configuration of the broach 100 isin position and any resection is complete, the surgeon may furtherprepare the medullary canal 82 and the femur 78 to receive a prostheticimplant. The surgeon may release the instrument handle 48 from thebroach 100 and remove the instrument handle 48. After removing theinstrument handle 48, the broach 100 and the reamer 12 remain seatedwithin the medullary canal 82. To continue preparation, the surgeon mayattach one or more other instruments to the broach 100 and/or reamer 12,such as cutting guides, adapters, trial components, or otherinstruments.

After completing preparation of the patient's femur 78, the surgeon mayreattach the instrument handle 48 to the broach 100 and remove thebroach 100 from the medullary canal 82. After removing the broach 100,the surgeon may also remove the reamer 12 from the medullary canal 82.After removal, the surgeon may proceed with implantation of prostheticcomponents.

While the disclosure has been illustrated and described in detail in thedrawings and foregoing description, such an illustration and descriptionis to be considered as exemplary and not restrictive in character, itbeing understood that only illustrative embodiments have been shown anddescribed and that all changes and modifications that come within thespirit of the disclosure are desired to be protected.

There are a plurality of advantages of the present disclosure arisingfrom the various features of the method, apparatus, and system describedherein. It will be noted that alternative embodiments of the method,apparatus, and system of the present disclosure may not include all ofthe features described yet still benefit from at least some of theadvantages of such features. Those of ordinary skill in the art mayreadily devise their own implementations of the method, apparatus, andsystem that incorporate one or more of the features of the presentinvention and fall within the spirit and scope of the present disclosureas defined by the appended claims.

1-5. (canceled)
 6. An orthopaedic surgical instrument assembly,comprising: a first broach segment including a tapered body extendingfrom a proximal end to a distal end, the tapered body having a pluralityof cutting teeth defined therein; and a second broach segment includinga tapered body extending from a proximal end to a distal end, thetapered body having a plurality of cutting teeth defined therein,wherein the proximal end of the second broach segment is removablycoupled to the distal end of the first broach segment; wherein whencoupled the first broach segment and the second broach segment cooperateto define a bore that extends from a first aperture defined in theproximal end of the first broach segment to a second aperture defined inthe distal end of the second broach segment, wherein the bore is sizedto slide over a shaft of a surgical reamer; and wherein when coupled thetapered body of the first broach segment and the tapered body of thesecond broach segment form a tapered outer surface that widens from theproximal end of the first broach segment to the distal end of the secondbroach segment.
 7. The orthopaedic surgical instrument assembly of claim6, wherein: the second broach segment includes a dovetail positioned onthe proximal end of the second broach segment; and a dovetail slot isdefined in the distal end of the first broach segment, wherein thedovetail slot is sized to receive the dovetail of the second broachsegment.
 8. The orthopaedic surgical instrument assembly of claim 6,wherein: the first broach segment includes a ball detent positioned onthe distal end of the first broach segment; and a recess is defined inthe proximal end of the second broach segment, wherein the recess issized to receive the ball detent of the first broach segment.
 9. Theorthopaedic surgical instrument assembly of claim 6, wherein the distalend of the first broach segment and the distal end of the second broachsegment are each configured to be removably attached to a surgicalinstrument handle.
 10. The orthopaedic surgical instrument assembly ofclaim 6, further comprising: a third broach segment including a taperedbody extending distally from a proximal end to a distal end, the taperedbody having a plurality of cutting teeth defined therein, wherein theproximal end of the third broach segment is removably coupled to thedistal end of the second broach segment; wherein when the third broachsegment is coupled to the second broach segment, the bore furtherextends to an aperture defined in the distal end of the third broachsegment, and the tapered body of the third broach segment extends thetapered outer surface that widens from the proximal end of the firstbroach segment to the distal end of the third broach segment.
 11. Theorthopaedic surgical instrument assembly of claim 10, furthercomprising: a fourth broach segment including a tapered body extendingdistally from a proximal end to a distal end, the tapered body having aplurality of cutting teeth defined therein, wherein the proximal end ofthe fourth broach segment is removably coupled to the distal end of thethird broach segment; wherein when the fourth broach segment is coupledto the third broach segment, the bore further extends to an aperturedefined in the distal end of the fourth broach segment, and the taperedbody of the fourth broach segment extends the tapered outer surface thatwidens from the proximal end of the first broach segment to the distalend of the fourth broach segment.
 12. The orthopaedic surgicalinstrument assembly of claim 11, further comprising: a fifth broachsegment including a tapered body extending distally from a proximal endto a distal end, the tapered body having a plurality of cutting teethdefined therein, wherein the proximal end of the fifth broach segment isremovably coupled to the distal end of the fourth broach segment;wherein when the fifth broach segment is coupled to the fourth broachsegment, the bore further extends to an aperture defined in the distalend of the fifth broach segment, and the tapered body of the fifthbroach segment extends the tapered outer surface that widens from theproximal end of the first broach segment to the distal end of the fifthbroach segment.
 13. The orthopaedic surgical instrument assembly ofclaim 12, further comprising: a sixth broach segment including a taperedbody extending distally from a proximal end to a distal end, the taperedbody having a plurality of cutting teeth defined therein, wherein theproximal end of the sixth broach segment is removably coupled to thedistal end of the fifth broach segment; wherein when the sixth broachsegment is coupled to the fifth broach segment, the bore further extendsto an aperture defined in the distal end of the sixth broach segment,and the tapered body of the sixth broach segment extends the taperedouter surface that widens from the proximal end of the first broachsegment to the distal end of the sixth broach segment.
 14. A method ofperforming an orthopaedic surgical procedure on a distal end of apatient's femur, the method comprising: advancing a cutting head of asurgical reamer into a medullary canal of a patient's surgicallyprepared femur, wherein the surgical reamer further includes anelongated shaft coupled to the cutting head; sliding a bore definedthrough the broach over the elongated shaft while the cutting head ispositioned in the medullary canal, wherein the bore defined through thebroach extends from a proximal end of the broach to a distal end of thebroach; and advancing the broach into the medullary canal after slidingthe bore defined through the broach over the elongated shaft.
 15. Themethod of claim 14, further comprising: attaching the distal end of thebroach to an instrument handle; wherein advancing the broach comprisesimpacting a strike plate of the instrument handle.
 16. The method ofclaim 15, further comprising sliding a bore defined in the instrumenthandle over the elongated shaft after sliding the bore of the broachover the elongated shaft, wherein the bore defined in the instrumenthandle extends distally from a first end of the handle.
 17. The methodof claim 14, further comprising: sliding a bore defined through a broachsegment over the elongated shaft, wherein the bore defined through thebroach segment extends distally from a proximal end of the broachsegment to a distal end of the broach segment, and wherein the proximalend of the broach segment contacts the distal end of the broach; andadvancing the broach segment into the medullary canal after sliding thebore defined through the broach shaft over the elongated shaft.
 18. Themethod of claim 17, further comprising: attaching the proximal end ofthe broach segment to the distal end of the broach after sliding thebore defined through the broach segment over the elongated shaft;wherein advancing the broach segment comprises advancing the broachsegment after attaching the proximal end of the broach segment.
 19. Themethod of claim 17, further comprising: removing the broach from themedullary canal after advancing the broach into the medullary canal; andattaching the proximal end of the broach segment to the distal end ofthe broach after removing the broach from the medullary canal.
 20. Themethod of claim 19, wherein sliding the bore defined through the broachsegment over the elongated shaft comprises sliding the bore definedthrough the broach and the bore defined through the broach segment overthe elongated shaft after attaching the proximal end of the broachsegment to the distal end of the broach.